Ilan Steven Schwartz

Background: The utility of follow-up blood cultures (FUBCs) in patients with gram-negative bacteremia (GNB) is unsettled. In practice, the use of FUBCs is variable. Understanding practice variation and drivers of FUBC ordering may clarify how clinicians identify patients at high risk for persistent GNB. Methods: We conducted a global survey (21 February 2024 to 9 April 2024) of healthcare workers using 10 hypothetical clinical scenarios to assess FUBC decision-making in GNB. Scenarios varied clinical factors and risk of persistence using the published AIMS scoring tool (Antibiotics, Infection source, Medical conditions, Serratia). The anonymous web-based survey was distributed via listservs, email, and social media. Interrespondent agreement was assessed using Fleiss’ kappa (κ). Mixed-effect logistic regression identified factors associated with FUBC recommendations. Results: Among 864 clinicians from 50 countries, 691 (80%) provided recommendations across 10 scenarios (6910 recommendations). Most were physicians (86.5%) and infectious disease specialists (79.7%). Follow-up blood cultures were frequently recommended, with >50% of clinicians endorsing FUBCs in 6 of 10 scenarios. Overall agreement was fair (κ = 0.26; 95% confidence interval, .10–.43). In adjusted analyses, factors associated with FUBC recommendations included female respondent sex (adjusted odds ratio [aOR] 1.40; P = .042), higher AIMS score (aOR 1.78 per point; P < .0001), older patient age (aOR 2.90; P < .0001), inadequate source control (aOR 4.77; P < .0001), and clinical instability (aOR 114.99; P < .0001). Conclusions: In this survey study, clinicians frequently recommended FUBCs, particularly in clinical vignettes with higher AIMS scores, inadequate source control, and clinical instability. Only fair agreement across risk-stratified scenarios suggests substantial practice variation and supports the need for prospective studies to understand when and in whom FUBCs should be used.

Emergomyces ( Ajellomycetaceae , Onygenales ) is a genus of dimorphic fungal pathogens that cause severe, opportunistic infections around the world. We used long-read nanopore sequencing to generate de novo genome assemblies followed by comparative analyses for the type-strains of Emergomyces africanus, Emergomyces canadensis, Emergomyces crescens, Emergomyces europaeus, Emergomyces orientalis , Emergomyces pasteurianus , and Emergomyces soli . The average Emergomyces genome was found to be 32,965,087 bp in size (range 28,687,700–35,863,369 bp) with GC%-contents of 42.01–45.72%. Average Nucleotide Identity analysis of the seven type-strain genomes with the publicly available Emergomyces and Blastomyces genomes was performed, showing values of 85–100% similarity between genomes and 85–91% between the twelve species tested. Furthermore, we formally validate the species descriptions for Emergomyces crescens and Emergomyces soli .

The Mycoses Study Group Education and Research Consortium (MSGERC)—a group comprising clinicians, researchers, patients, and industry partners—meets every 2 years to review the most significant challenges facing the clinical mycology community and plan research, education, and advocacy strategies to prevent fungal infections and improve outcomes. Key themes of the 2024 biennial meeting included emergence of antifungal resistance, the effects of climate change on incidence of IFI, recent healthcare‐and community‐associated outbreaks and their management, and the potential benefits of novel approaches, such as innovative study designs, host‐directed diagnostics and therapies, and artificial intelligence in clinical and academic mycology.

This article is part of a larger clinical practice guideline on the management of histoplasmosis in adults, children, and pregnant people, developed by the Infectious Diseases Society of America. In this article, the panel provides recommendations for treatment of mild and moderate acute pulmonary histoplasmosis. The panel's recommendations are based upon evidence derived from systematic literature reviews and adhere to a standardized methodology for rating the certainty of evidence and strength of recommendation according to the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach.

The field of infectious diseases is at a perilous moment in our history, with the United States executive branch of government and congressional enablers contemptuous toward truth, public health, and social justice, implementing regressive policies that promise to undo decades of scientific and social progress and directly threaten the lives of individuals from vulnerable communities that we serve around the world. In this perspective, we recount the early executive actions that impact every aspect of the field infectious diseases. Inspired by LGBTQ+ community activists and early human immunodeficiency virus (HIV) clinicians who overcame hostile political forces, we implore the infectious diseases community to urgently and forcefully defend the people for whom we care, the public health institutions on which we rely, and the principles in which we believe.

Social media provides platforms for transplant infectious diseases (TIDs) clinicians to network, exchange ideas, and educate each other and the broader public. A #TxIDChat on the social media platform X was conducted on the perceptions of social media in TID by the account @TxID_Fellows. This article examines the current usage of social media by TID clinicians, and its role in education, patient outreach, and networking. Guidance is also provided for trainees to help navigate a public space at the intersection of professional and social platforms. image

Nicolás Cortés-Penfield, Ilan S Schwartz; Safe implementation of large language models in clinical care requires acknowledgment of their limitations and st